Dorsal or Lateral Approach for Intramedullary Nailing Using Kirschner Wire in Pediatric Radius Diaphyseal Fractures: Does it really matter?

Autor: Akgülle AH; Department of Orthopaedics and Traumatology, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey., Onay T; Department of Orthopaedics and Traumatology, Dr. Lütfi Kırdar Kartal City Hospital, Istanbul, Turkey., İğrek S; Selahattin Eyyubi State Hospital, Diyarbakir, Turkey., Kesimer MD; Department of Orthopaedics and Traumatology, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey., Topkar OM; Department of Orthopaedics and Traumatology, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey., Şirin E; Department of Orthopaedics and Traumatology, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey.
Jazyk: angličtina
Zdroj: Indian journal of orthopaedics [Indian J Orthop] 2021 Mar 07; Vol. 55 (Suppl 2), pp. 323-329. Date of Electronic Publication: 2021 Mar 07 (Print Publication: 2021).
DOI: 10.1007/s43465-021-00384-8
Abstrakt: Background: Intramedullary nailing is the most preferred fixation method for diaphyseal radius and ulna fractures in the young age group. The aim of this study was to compare the dorsal and lateral entry points in the context of entry site-related complications, fracture union and functional results.
Methods: This retrospective comparative study included pediatric patients who underwent surgery for isolated diaphyseal radius or both bone forearm fractures with intramedullary nailing using Kirschner wire between January 2013 and January 2019. K-wire was introduced from the distal radius through dorsal entry ( Group A) in 19 patients and lateral entry (Group B) in 18 patients. The mean follow-up was 37 months. Complications were noted and functional outcomes were evaluated according to the CHOP criteria.
Results: All fractures were healed. The functional results were determined to be excellent for 30, fair for 4, and poor for 3 patients. The overall complication rate was 18.9%, including distal radius fracture, mild pain in the wrist, and minor loss in ROM. No statistically significant differences were determined between the groups in respect of functional results and complication rates.
Conclusion: Good functional results and similar complication rates can be obtained with both dorsal and lateral entry approaches. Stainless steel K-wire is an inexpensive intramedullary fixation implant option, which provides strong stabilization. Distal radius fracture is a newly reported complication for forearm intramedullary nailing. Leaving the implant out of the skin seems safe with the benefit of avoiding a further surgical intervention to extract the implant.
Competing Interests: Conflict of interestOn behalf of all authors, the corresponding author states that there is no conflict of interest.
(© Indian Orthopaedics Association 2021.)
Databáze: MEDLINE
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